Diagnostic performance of PET for detection of cardiac amyloidosis: A systematic review and meta-analysis

J Cardiol. 2020 Dec;76(6):618-625. doi: 10.1016/j.jjcc.2020.07.003. Epub 2020 Jul 15.

Abstract

Objectives: The purpose of the current investigation was to evaluate the diagnostic accuracy of amyloid and F-18 sodium fluoride (NaF) positron emission tomography/computed tomography (PET/CT) for the detection of cardiac amyloidosis (CA) using diagnostic accuracy test.

Materials and methods: The PubMed, Cochrane, and EMBASE database, from the earliest available date of indexing through February 29, 2020, were searched for results investigating the diagnostic accuracy of amyloid and F-18 NaF PET for the diagnosis of CA. We calculated the pooled sensitivities and specificities of included studies, calculated positive and negative likelihood ratios (LR+ and LR-), and obtained summary receiver operating characteristic (SROC) curves.

Results: Across 13 studies with 14 results (90 patients), the pooled sensitivity of amyloid PET was 0.97 and a pooled specificity was 0.98. The pooled sensitivity of F-18 NaF PET was 0.63 and a pooled specificity was 1.00. The pooled sensitivity of combined amyloid and F-18 NaF PET was 0.88 and a pooled specificity was 0.98.

Conclusion: Amyloid PET has a high sensitivity and specificity for the detection of CA. However, F-18 NaF PET showed relatively low sensitivity with high specificity. At present, the literature regarding the use of amyloid and F-18 NaF PET for diagnosis of CA is still limited; thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of amyloid and F-18 NaF PET for detection of CA.

Keywords: Amyloid positron emission tomography; Cardiac amyloidosis; F-18 sodium fluoride.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Amyloidosis / diagnostic imaging*
  • Fluorodeoxyglucose F18
  • Heart Diseases / diagnostic imaging*
  • Humans
  • Positron Emission Tomography Computed Tomography / methods*
  • Radiopharmaceuticals
  • Sodium Fluoride

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Sodium Fluoride